Post-op rehabilitation program for ACJ reconstruction
Problem: ACJ dislocation with reduced range of movement and shoulder pain
Aim: to stabilise ACJ, increase range of movement and reduce pain
Important points: to remain in sling for four weeks
Forbidden:
● heavy activities or heavy work before 12 weeks
● no heavy activities or sport above shoulder height and arm pulled back for 3 months (ABER position)
Expectations:
● return to desk jobs at 3-6 weeks
● driving at 6-10 weeks (if pain and function allows safe driving)
● breaststroke swimming at 10 weeks
● contact sports and freestyle swimming at 4 months
Physiotherapy protocol day 1 onward:
● Ensure adequate pain relief, neuro-vascular status normal and no signs of infection
● Hand and elbows exercises
● Pendulums and circles
● Active external rotation and internal rotation
● Shoulder shrugs and scapular exercises
● Sling for first 4 weeks Physiotherapy protocol day 21 onward:
● Begin to wean out of sling over next 3 weeks
● Begin active assisted forward flexion and abduction
Physiotherapy protocol week 7 onward:
● Active range of movement throughout
● Once achieved concentrate on scapular control and strength exercises
Protocol from 4 months onward:
● Return to sports and full activities if regained full ROM and 90% strength of contra-lateral side